Overview
The NHSScotland Design Assessment Process (NDAP) was introduced in 2010 as a means of helping Boards describe a clear path between the business objectives for a project and the necessary qualities of the building development. Project specific design standards (called a SCIM Design Statement) are developed pre-Initial Agreement (IA) and incorporated into the project's governance. The process then provides assistance in checking the project is on target to meet these objectives and national standards for healthcare design and sustainability, providing comfort to decision-makers at key points.
NDAP is mandatory for all projects over the commissioning Board’s delegated authority. It requires formal reporting to be produced in the run up to each business case point (IA, OBC, and FBC/SBC), but we encourage client teams to discuss proposals during their development so that issues can be identified early and resolved prior to formal reporting. The staff at HFS and A&DS are here to help you at each step of the way.
The following information describes the aim of each stage of development and show how we can help you to get the most out of your project.
Help preparing Design Statements
Projects always should start with a view of how services in an area need to change. As it becomes clear that meeting these needs will require the development of new or substantially altered buildings an Initial Agreement will need to be developed which describes the strategic needs and objectives for the development along with potential costs. Within this there should be the strategic design brief for the project. This brief is set out in a 'SCIM Design Statement' which describes the key attributes and qualities that the facility should possess to meet the needs of patients, staff and visitors, and also how the investment in the community can realise broader benefits. Links to example SCIM Design Statements can be found via this page.
Design Statements are best developed through engagement with a broad base of stakeholders. These stakeholders can collectively consider what new service modes need to be addressed and then describe ‘non-negotiable’ attributes for the facility that will form the basis for assessing the design during its development.
A&DS can help facilitate these sessions, and also offer web based resources which can both help clients understand how others have tackled similar issues and provide potential benchmarks – views of what success might look like. At the end of the process, the client team should have a Design Statement that sets a brief that works for them and their needs. This can then be incorporated into the IA and also used to help inform and inspire stakeholders of the benefits and brighter future that will result from the hard work necessary to realise the vision being established.
A typical process is shown below. Depending on the scale and complexity of the project, and the availability of stakeholders, it can take 1-2 months to be developed and signed off by the project team. This process is important as once the Design Statement is completed and incorporated into an approved IA, it forms part of the Board’s commitment to Government on the nature and quality of proposed facility, as well as the basis for future design assessments by NDAP. It can provide informal feedback on the developing document throughout this process to provide an assurance of acceptability at the formal IA review point.
''Without the NHS design assessment process, the blood transfusion centre would've probably focused exclusively on regulatory compliance. I don't think we would've looked at staff needs."
- Susan Rossborough, Client Lead
Initial Agreement Formal Report
A formal report is required from NDAP prior to consideration of the IA. This report must state if the project is supported or not, and CIG have made it clear that they do not expect to approve business cases that are unsupported by NDAP. Therefore it is important that this formal stage progresses smoothly.
At IA stage, we are looking for the following:
• Clear line of sight between the business objectives and the 'non-negotiable' design objectives.
• That the difficult aspects of briefing – such as flexibility in use, benefits of co-location etc – have been tackled and a direction of travel is described.
• Benchmarks that relate to the ‘non-negotiables’ and which are based on recent relevant good practice.
• A clear view of how the development can benefit the wider community.
• A ‘self assessment process’ that will support delivery.
• That the design statement is embedded into the IA and project governance in a clear and simple manner, without undue duplication in assessment processes or design objectives that could cause difficulties in the project later.
• NDAP ask for 2 weeks’ notice of a submission, and a further 2 weeks to respond. Notification and submission forms and criteria are available here and should be sent to HFS and copied to A&DS for speed. Submission of draft information nearing completion is perfectly acceptable – the process does not require a delay in the development and sign-off of the document.
If there are aspects of concern that have not already been addressed by this point (see earlier stage) we may ask for changes or for evidence to be provided by the Board before we will verify support to CIG. The report we provide should be used to inform the approval of the IA by the Board, and subsequently by CIG.
Support during Outline Business Case Development
During this stage A&DS and HFS encourage project teams to get support and feedback on the design development so that issues can be identified and resolved well in advance of formal reporting at OBC. Given that each project is unique, there is no formal set structure for engagement at this stage; a note of the anticipated 'formal' engagement will be included in the IA stage report, however A&DS and HFS are here to help and can tailor support based on the project and the project team’s needs. This can range from early advice and guidance on site selection, through to informal feedback on developing design options. Informal feedback is particularly helpful if a decision is being taken that might affect the performance of the design against key objectives and you would not want to wait until OBC to check that it would be supported by NDAP. We also provide more formal reports though Desktop or Panel Assessments to allow for inclusion in Planning processes that may run ahead of OBC stage; for example, where a masterplan is to be established with Planning Permission in Principle.
Assistance at this stage aims to set the right overall design strategy regarding:
• Location in the community.
• Site strategy including transport/parking/routes, useable green space and response to the local built form.
• Building circulation routes for patients, staff FM etc.
• Orientation of major elements for daylight/privacy/views.
• Sustainability strategy in terms of natural light, ventilation and approach to M&E. HFS can assist in establishing the target BREEAM scoring etc.
• Any feedback and reports provided in this manner can be wrapped into formal reporting at OBC stage, therefore, this early engagement ensures there are no surprises at the formal review point.
"The design statement helps you deliver the vision. A vision is a very difficult thing to encapsulate; actually having something illustrated and written down gives you a language and something you can share easily."
- Dr Safia Qureshi, Project Director
Outline Business Case Formal Report
A formal report is required from NDAP prior to consideration of the OBC by key decision makers. This report must state if the project is supported or not, and CIG have made it clear that they do not expect to approve business cases that are unsupported by NDAP. Therefore, it is important that this formal stage progresses smoothly.
At OBC stage, we are looking for the following:
That the building design concept (be that reference design for an NPD project or proposed design for any other project) is exhibiting the qualities described in the Board's Design Statement.
• That the correct Healthcare Design Guidance is being applied to the project and any derogations to guidance are understood.
• That the building diagram demonstrates a sensible approach to fire and escape.
• That the approach to sustainability is well understood and the development is on target to reach the required BREEAM score.
• That design risks are understood and being well managed into the next stage of development – particularly where NPD procurement is proposed and the aspects above will largely be addressed through the subsequent bidding stage.
• That the proposed development sits well within its setting and that the approach to Planning is being well handled.
• That the opportunities of the site and design are being maximised both for the specific development and wider agendas, like health promotion and biodiversity.
• NDAP ask for 2 weeks’ notice of a submission, and a further 2-3 weeks to respond. In reality though, this can take longer, particularly if there are a number of aspects that remain unresolved (or not evidenced) from the previous stage and meetings become necessary to discuss and agree approaches to addressing these matters. Notification and submission forms and criteria are available here and should be sent to HFS and copied to A&DS for speed. Submission of draft information nearing completion is perfectly acceptable – the process does not require a delay in the development and sign-off of the document.
The client, and potentially the design team, will be generally consulted during the assessment period to ensure the design is understood – though this may not be necessary if this dialogue has been carried out in the earlier informal stage.
If there are aspects of concern that have not already been addressed by this point (see earlier stage) we may ask for changes or for evidence to be provided by the Board before we will verify support to CIG. The report may include recommendations to be discharged early in the next stage.
The report we provide should be used to inform the approval of the OBC by the Board, and subsequently by CIG. It can also be used as evidence of consultation with A&DS in the approach to the Planning Authority.
Support during Full Business Case Development
Like OBC development, there is no set structure for support during FBC development, though the anticipated nature and timing of engagement will be given in the OBC response to guide the client group on what is expected.
Early engagement is likely to be around ensuring OBC stage recommendations are considered to have been discharged, as failing to address these could result in the project being unsupported at FBC. Subsequently, advice, guidance and feedback will often be of a more technical nature, though where NPD procurement is used, the developing bidders designs will likely also be addressing aspects such as site and building strategy. There is of course scope for NDAP to offer other guidance and support if the project team feel it would be beneficial.
Any feedback and reports provided in this manner can be wrapped into formal reporting at FBC stage, therefore, this early engagement ensures there are no surprises at the formal review point.
Full Business Case Formal Report
A formal report is required from NDAP prior to consideration of the FBC by key decision makers. This report must state if the project is supported or not, and CIG have made it clear that they do not expect to approve business cases that are unsupported by NDAP. Therefore it is important that this formal stage progresses smoothly.
At FBC stage, we (HFS & A&DS) are looking for the following:
• That the building design is exhibiting the qualities described in the Board's Design Statement and that the recommendations noted at OBC have been addressed.
• That the correct Healthcare Design Guidance is being applied to the project and any derogations to guidance are understood.
• That development is on target to reach the required BREEAM score and that the anticipated energy use is minimised; for this we are now looking at the BRUKL document which describes the likely performance in greater detail.
NDAP ask for 2 weeks’ notice of a submission, and a further 2-3 weeks to respond, though in reality this can take longer particularly if there are a number of aspects that remain unresolved, or not evidenced, from the previous stage and meetings become necessary to discuss and agree approaches to addressing these matters. Notification and submission forms and criteria are available here and should be sent to HFS and copied to A&DS for speed. Submission of draft information nearing completion is perfectly acceptable – the process does not require a delay in the development and sign-off of the document.
The client, and potentially the design team, will be generally consulted during the assessment period to ensure the design is understood – though this may not be necessary if this dialogue has been carried out in the earlier informal stage.
If there are aspects of concern that have not already been addressed by this point (see earlier stage) we may ask for changes or for evidence to be provided by the Board before we will verify support to CIG. The report we provide should be used to inform the approval of the FBC by the Board, and subsequently by CIG.
SCIM
Find supporting guidance on SCIM here
Design Statements
Find links to example completed SCIM Design Statements here.
Pulse Projects and Gallery
Access our database of healthcare project case studies here, and our catalogue of images which can be used in SCIM Design Statements here.
Contact
A&DS
0131 556 6699
health@ads.org.uk
HFS
0141 207 1600
nss.hfsdesignassessment@nhs.net
